Provider Demographics
NPI:1225222581
Name:OLIVA, ANDREA CAROLINA (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:CAROLINA
Last Name:OLIVA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2580 JUDGE FRAN JAMIESON WAY UNIT 3113
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-6240
Mailing Address - Country:US
Mailing Address - Phone:954-647-7386
Mailing Address - Fax:
Practice Address - Street 1:1333 GATEWAY DR STE 1014
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-2647
Practice Address - Country:US
Practice Address - Phone:321-432-2572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 241232251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics